Today I counseled one discharge patient on her meds for 30 minutes. In case you didn’t know, the IHS is required to counsel on each patient each time. It doesn’t matter if the drug is new or a refill. So this lady had at least 10 meds. I counseled on each one and gave her one of my medication calendars. I started on this calendar during my first rotation and was able to finish it this rotation. It’s a monthly calendar where the patient can check off each time they take their med for each day of the month.

Friday, xx/15/xx

So I had Coumadin clinic today. It was my second time so the pharmacist gave me more responsibilities. He asked me whether the dose should be lowered, kept the same, or increased for some of the patients. A few times during the day when I called in the next patient he would just leave for some reason so I ended up deciding the drug dosage as well as counseling the patient. Of course, I would wait until he came back to check if he agreed with my plan.

I really like clinics and ambulatory care in general. It is one of the few things in pharmacy that I can see myself doing for the rest of my life. I don’t like hospital inpatient or outpatient. I don’t like retail. I don’t like research. I don’t like management. I’m just glad I know what I want to do in pharmacy before I graduate.

Saturday, xx/16/xx

Today, I traveled San Juan Skyway aka “The Loop”. It’s beautiful. I took some gorgeous photos.

Monday xx/18/xx

Today’s about the midpoint of my rotation. My preceptor gave me his midpoint evaluation of me. It wasn’t as good as I thought it would be. Basically he said, “You’re passing right now, I can’t give you a high pass or honors as of now. After talking to some pharmacists, it seems like you lack motivation.” ???? Ok, maybe there is some misinterpretation going on. If a pharmacist asks me to do something, I’ll be polite and do it. I won’t flash a gigantic smile and clap my hands and say,”Yeaaah!!!!” Anyways, I did well in my previous rotations and maybe this is just miscommunication. I’ll just have to up my game and change their interpretation of my behavior.

Saturday xx/23/xx

Today I went to the flea market, befriended a stray dog, and visited “the Rock”.

So I started the day with my roommate at the flea market. We went around to the different vendors for about an hour. There we the fried bread and mutton. The bread was pretty good but the mutton was chewy as hell. I decided I couldn’t finish the bread and mutton and packed it to go. As we walked back to our place, a stray dog crossed the street and followed us. He followed us a mile to our place. We decided to feed him and pamper him. Then my roommate and I decided to go sightseeing. He picked up the dog and put him in the back of the station wagon. LOL. Went we got to the sightseeing place, we put the dog on a leash and explored the rocks. Surprisingly the dog didn’t’ complain about being leashed. After enough exploration we went back home. We took the leash off the dog and he sat in front of the house for a few hours. Then after a while he disappeared. We haven’t seen him since then. Funny Dog.

I’ve copied and pasted a journal I kept during my IHS rotation. I’ve removed a few sentences and changed the dates b/c I want to remain anonymous. I hope you enjoy the pics b/c they are magnificent.

IHS Journal

Friday, xx/01/xx
I’m stuck in Denver, CO because my flight from Denver to Durango got cancelled. It’s not bad though. United Airlines is sticking me in the Marriot Hotel until my next flight. I have to admit the Marriot is one of the nicer hotels I’ve stayed in.

Oh, for some reason, the bible people popped up in my head so I decided to look in all the drawers. Haha, I found the King James Version of the Bible.

Saturday, xx/02/xx
Flying to Durango.

Sunday, xx/03/xx
My kind guests showed me some pretty places at the Fort Lewis College in Durango, CO. It is beautiful. The whole state of Colorado is beautiful in general. It is very different from the flashy and overcrowded places like New York and Las Vegas. Here I am on some various hiking trails around Fort Lewis College which is about 1 mile above sea elevation. From here are various photos of the horizon and downtown Durango.

I left in the early afternoon to travel to my IHS site on Navajo Territory. You know, it’s not as desolate as I thought. There are a bunch of restaurants around and even a medium-sized grocery store. The only thing I don’t see are young, attractive women, hehe. The free housing I’m at is pretty decent. It’s like a house. There are three bedrooms, a bathroom, a kitchen, and a living room. Furniture, microwave, fridge, laundry, and dryer are provided. There’s suppose to be a TV but I don’t see one. Oh yea, there is also no Internet . . . Overall though, I’m pretty satisfied. I thought I would be in a small room having to share the bathroom with the whole floor. But this is just like renting a house. Well, I need to finish unpacking and then sleep. Tomorrow I start my rotation . . .

Sat xx/09/xx

Today was an enjoyable day. My rotation partners and I left our place at around 8am. We went to Mesa Verde National Park in Colorado. Basically the park consisted of cliff dwellings. These houses were carved into the rock by Native Americans hundreds of years ago. Overall, Mesa Verde was decent. It was nice to see these dwellings that were etched into the face of the mountain. Also, the guided tours were a good workout. My complaint was that the park rangers who guided the tours talked too much, though. I could have admired the dwellings in 20 minutes instead of an hour.

After Mesa Verde we went to an Indian Casino. First I had only $20 on me. Playing $5 blackjack, I lost all 20 bucks in 4 straight hands. Then I did something I usually don’t do . . . I withdrew money ($40 from the ATM). With the $40 I played some more blackjack. However, this time lady luck smiled at me and over the course of about 30 minutes, I went up to $100. So I cashed out and made a nice profit of $40. Woot. Woot.

After that, we went to Four Corners Monument. Oh man, this place is so lame it’s fun. This spot is where New Mexico, Arizona, Colorado, and Utah all meet. On flickr is a photo of me with one limb in each state.

First week of IHS rotation
Everyone and I mean everyone from the nurses to the physicians to the pharmacists are nice. I think they put benzos and SSRI’s in the water. Seriously, the only people I’ve seen without a smile are the janitors. I’ve been doing a lot of discharge counseling, prescription checks, drug info questions, and some IV’s. I don’t start clinics until next week. Being an amb care rotation, I’m a little disappointed. I’ve already done all the inpatient stuff before and will get to do it in my future hospital rotation. I expected to be in a clinic most of the time. I will talk to my preceptor next week and see if he can give me more time in the clinic.

Sunday, xx/10/xx
I just lost $80 playing blackjack at an Indian Casino . . .

The poem in my previous post is one of my favorites. Why? Its lines are filled with sadness and at first read it seems depressing. “The day is cold, and dark, and dreary . . . dead leaves fall . . . My life is cold . . . hopes of youth fall think in the blast . . .” You can’t get more emo than that.

However, the last stanza tells us that everyone has their depressing moments. “Into each life some rain must fall.” Those moments are necessary in order for us to appreciate the good times we have. No matter how down we feel, the sun is right behind the current veil of unhappiness.

The day is cold, and dark, and dreary
It rains, and the wind is never weary;
The vine still clings to the mouldering wall,
But at every gust the dead leaves fall,
And the day is dark and dreary.

My life is cold, and dark, and dreary;
It rains, and the wind is never weary;
My thoughts still cling to the mouldering Past,
But the hopes of youth fall thick in the blast,
And the days are dark and dreary.

Be still, sad heart! and cease repining;
Behind the clouds is the sun still shining;
Thy fate is the common fate of all,
Into each life some rain must fall,
Some days must be dark and dreary.

Anki is my favorite learning software. I think it might be my favorite software overall. It is SO efficient. It’s a flashcard program based on spaced repetition learning theory. Anki has four options where you can mark it “again”, “hard”, “good, or “easy”. You know how you make paper flashcards and then go over them over and over again? Well, that’s a waste of time because you’re reviewing the cards you know too often and the ones you don’t know too late. But in Anki, if you mark “hard”, it’ll show the card sooner. If you mark it “easy” it’ll show the card much later. Very efficient. If you wanna learn more about spaced repetition, click on the following jump. I love you Anki.

Also, Anki allows you to type in your answer. For me, I made cards to practice typing brand and generic. I also have the dose on each side. It’s almost exactly like taking those damned quizzes in skills lab. I’ll try to upload the deck later.

Also, Anki can be run on your desktop, through your web browser, on your phone, or IPOD touch. It syncs itself so if you study online and then use the touch, you’ll start where you left off. I love you Anki.

Oh yea, anki is FREE!!!!!!

I know this sounds like a commercial for Anki, but that’s because I really love it. I discovered this fine piece of ass . . . I mean software this past summer. My only regret is not finding it 2 years ago when I started rx school. This semester, I’m gonna start an experiment by putting in Anki ALL my notes and just studying that way. I really suggest you all try Anki, you have nothing to lose. I love you Anki!

This past Thursday I had surgery on the inside of my nose. The septum (the lining that seperates the two nostrils) was crooked. This was probably due to the times I got hit in the nose while playing soccer/basketball during high school and college. I also had my turbinates (fleshy part inside the nose) shrunken to allow more air flow. I decided to have this surgery because I had so much nasal congestion the past few years. It was interfering with my sleep, my studying, and my overall life. I visited an ear, nose, and throat doctor and he confirmed my suspicions. He said, “Yep, you have a deviated septum.”

Day 1

Surgery only took about an hour. When I woke up, I felt very out of it. When I got home, my nose start to hurt and bleed profusely. I felt like someone punched me hard in the nose so I took a Percocet and laid down and pinched my nose to stop the bleeding. In addition, I had to breathe through my mouth because my nose was stuffed. It didn’t help that my throat was sore because there was a breathing tube during surgery. I made sure to take all my drugs on the first day. They were methylprednisone (to lessen swelling & inflammation), cephalexin (to prevent infection), and Percocet (for pain).

Day 2

I feel better now. My throat isn’t as sore and the bleeding has slowed down. Because of my lack of appetite yesterday and today, I lost about 3 pounds. I’m continuing to take my trio of drugs. I also was able to start rinsing the inside of my nostrils with the sinus rinse.